Is a higher body mass index associated with longer duration of survival with disability in frail than in non-frail older adults?
Authors' conclusion
Higher BMI is associated with a longer duration of survival with disability among older adults, especially in those with frailty. Therefore, reversing frailty should be prioritised because individuals with frailty have a shorter probability of disability-free survival than do individuals without frailty, regardless of BMI.
Study context
- Population
- Japanese adults aged ≥65 years, Kyoto-Kameoka Study 2011–2016; frailty assessed with the Kihon Checklist
- Participants
- 10,232 adults45,472 person-years
- Exposure
- Body mass index (BMI) categories, with and without frailty
- Outcome
- Disability incidence
- Follow-up
- 5.3-year median
Methodological detailsKyoto-Kameoka Study, multivariate Cox proportional hazards models and Laplace regression
- Kyoto-Kameoka Study
- Multivariate Cox proportional hazards models and Laplace regression
Main finding
As reported in the abstract
Disability (adjusted HR vs BMI 21.5-24.9 kg/m²)
Each group vs 21.5-24.9 kg/m²Hazard ratio (95% CI)P value
<18.5 kg/m²
1.31(1.16–1.49)
p for non-linearity <0.001≥27.5 kg/m²
1.27(1.08–1.49)
p for non-linearity <0.001- Disability incidences, overall
- 2348 (22.9%)
Observational data: associations, not effects.
Further findings
Months
| Outcome | <18.5 kg/m² | ≥27.5 kg/m² |
|---|---|---|
| Survival with disability (overall survival - disability-free survival), 50th percentile difference in age | −10.2 | 12.5 |
Survival with disability (overall survival - disability-free survival), 50th percentile difference in age
- BMI <18.5 kg/m² more likely to die before disability incidence; BMI ≥27.5 kg/m² longer survival with disability
Survival with disability, BMI ≥27.5 kg/m², by frailty
Months
- With frailty
- 27.2
- Without frailty
- 6.2
- Frailty-stratified model; relationships more marked
Original publication
Is a higher body mass index associated with longer duration of survival with disability in frail than in non-frail older adults? Int J Obes (Lond). Published 15 November 2024. doi:10.
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